High Yield Neurology Review
AIM: Discuss core Neurology material for NBME shelf preparation.
- Supplement core reading by engaging in a clinical discussion.
- Highlight the problem-based approach to a symptom and specific neurological disorders.
- Appreciate medical management issues for common neurologic disorders. Topics might include the Stroke, Disorders of Consciousness, Neuropathy, Headache, Parkinson’s Disease, Multiple Sclerosis, etc.
Preparation: Review reading material on topic to be discussed so you can optimally participate and assimilate the information.
Oral Presentation Skills Workshop – Lecture Powerpoint Slides
Oral Presentation Algorithm
AIM: Students will provide clear, concise, and well-organized patient presentations for rounds.
- Present a new patient from a symptom-based approach within 5-10 minutes.
- Presentations will be composed, clear, logical, and concise.
- Structure and organize presentations towards the differential diagnosis.
- Illustrate knowledge about localization and differential diagnosis by the use of pertinent positives and pertinent negatives, in appropriate places.
- Assessment and plan will integrate all prior material to demonstrate case synthesis and understanding.
Neurologic Exam Skills Workshop – Lecture Powerpoint Slides
AIM: Students will master the screening neurologic exam during their clerkship.
- Perform a comprehensive neurologic exam on a healthy individual.
- Sequence the exam so it proceeds in a logical manner.
- Demonstrate technically correct use of testing components and instruments.
- Recite what one needs to observe for each component.
Preparation: YOU MUST PREPARE BY REVIEWING THE EXAM SCRIPT. All students will prepare a neurologic exam based upon a provided script, and perform the exam on each other. Review the script prior to this session, and begin to incorporate it with your patients. Exam feedback will be provided by the examinee and Dr. Naismith.
Student Bedside Teaching Rounds
AIM: Provide cross-exposure to other neurological services, appreciate how to synthesize the case history to pro-actively localize, create a prioritized differential diagnosis, and to build expectations for the neuro exam.
- Feel more comfortable with the clinical approach to a common symptom or problem
- Understand how the history is used to make and test hypotheses.
- Approach the exam witha priorihypotheses and localizations.
- Synthesize the available data to construct a prioritized and complete differential diagnosis.
- Order labs and tests based upon prioritized differential, key questions, and to optimize short and long-term management.
Preparation: Either the attending or the student will briefly present a case from their service, to be seen at the bedside. This time can be used to highlight key components of the history, neurological findings, practice or the neuro exam, reviewing imaging, and discussion of differential and patient management.
Localization and Imaging Workshop with Dr. Van Stavern
Lecture Powerpoint Slides – Lecture 1, Lecture 2, Lecture 3, & Lecture 4
AIM: Students will participate in a round-table discussion in reviewing neuroanatomy, learning about the interpretation of imaging studies, and applying localization strategies for formulating a differential diagnosis.
- Apply a structured method to localization for patients on neurology.
- Describe the reasons for bright and dark signal on a CT scan and standard MRI sequences.
- Identify key neuroanatomical locations based upon CNS imaging.
Preparation: Review neuroanatomy material and lecture from second year Diseases of the Nervous System course, in addition to relevant chapters in your selected clerkship text. Review material on imaging.
LP Simulation Workshop – Lecture Powerpoint Slides – Lumbar Puncture Video
AIM: Students will perform a lumbar puncture with attention to technique and patient comfort.
- Be able to explain the rationale for an LP, the procedure, and complications to the patient to obtain informed consent.
- Prepare the patient for proper positioning; prepare yourself and the tray for comfort.
- Obtain fluid using sterile prep and drape, along with an opening pressure.
Preparation: YOU MUST PREPARE BY REVIEWING THE ONLINE LUMBAR PUNCTURE VIDEO. This session will have two components. The first is a simulated patient for informed consent and positioning. The second is an LP simulation mannequin to perform the actual procedure.
Neurology Grand Rounds (All students except those on Neurosurgery, Fri 7:45 am)
Departmental weekly lecture by a visiting professor or a faculty member. Connor Auditorium in the Farrell Learning and Teaching Center. Runs from September through May.
Neurosurgery Student Conference(All students, Tue 7:00 am)
AIM: Review core neurosurgery material. A sign-in sheet is provided. No food is allowed. Conference schedule is located here.
Dr. Landau’s Ethics Conference (All students, last Wed 4:00pm)
AIM: Present, discuss, and resolve several examples of ethical conflicts witnessed during the Neurology rotation. Become more aware on a personal and professional level of how our practices affect others.
- Actively reflect upon Neurology Clerkship experiences, and seek a controversy or conflict to present in conference.
- Concisely present an ethical dilemma, including the different points of view.
- Discuss a conflict in terms of Ethical Principles (below).
- Reconcile the conflict among peers.
The person who submitted the case shall briefly describe the situation. Discussion will ensue amongst the committee members to distill the case in terms of ethical principles.
- Beneficence (first, do no harm)
- Common good (society vs. the individual)
- Justice (access and rationing)
- Fidelity and Responsibility (doctor-patient relationship, abandonment)
- Integrity (accuracy and honesty)
- Dignity (every human is unique, equal, and has free will)
- Informed consent (competency and disclosure)
- Proportionate means (benefits vs. risks, reasonable hope vs. burden)
- Religious freedom (refusal of treatment based upon religion or conscience)
- Autonomy (choice, paternalism, confidentiality, privacy)
- Respect for persons (protection of the vulnerable)
- Stewardship (respect for creation and life, cloning and technology)
Additional Lectures and Conferences
Check with your residents for other conferences. Those listed above take priority, but there are many other conferences depending upon whether you are on adult, peds, or neurosurgery selectives.